Department of Safety and Security

Example of Patrol Log

Officer . . Radio Number U4 Vehicle Registration Explorer Start Mileage 9870 From: (Date) 07/15/09 Time: 2200 hours

First Aid Kit Yes Unlock Kit Yes Badge Number 13 Jumper Yes Vehicle Damage none End Mileage 9877 To: (Date) 07/16/09 Time: 0600 hours

Time
Activity Location Details and Action Taken
IN OUT

10:00 10:10 In Service 5102 Relieve Officer Leslie; Briefing; Exchange Phone; Car keys; Advised someone may still be occupying the gym

10:15 10:30 Email 5102 Check and respond to email

10:40 11:15 Patrol 3000 Contacted individuals in the gym who were playing BB. No faculty or supervisor present; Requested they leave. Checked out the

entire building. Found exercise equipment room w/light on and door unlocked. Secured it; secured building.

11:20 11:40 Patrol Campus Vehicle Patrol of campus; Dog park area; down to Greenwood lot - All clear

11:40 12:00 Patrol Cosmo Patrol down to Cosmetology - building secure; gate open; secured gate

12:10 12:30 Assist 1500 Custodian locked himself out of closet; assisted w/unlock

12:30 1:15 False Alarm 800 Staff leaving building tripped alarm; WA Alarm called; Responded to building and reset panel with staff member.
1:30 2:30 Patrol Campus Foot Patrol - Found Room 2930 & 1103 unlocked. Secured.

2:40 3:10 Lunch

3:20 3:50 Patrol Campus Vehicle Patrol - Dog Park, Automotive, Student lots. Car left in lot north of 2900 bldg. - Plate # ORP123; Note left for supervisor

4:00 5:45 Unlock of Campus Unlock of scheduled buildings; Found women's restroom at 1300 unlocked.

5:50 6:00 Briefing 5102 Brief on-coming Officer - hand-off keys and phone.

6:05 5102 Secure

 INCIDENT NUMBER
SAFETY & SECURITY DEPARTMENT
INCIDENT REPORT
CONFIDENTIAL INFORMATION - NOT FOR UNAUTHORIZED DISCLOSURE PAGE 1 of 1

INCIDENT DESCRIPTION: DATE OF INCIDENT: TIME OF INCIDENT:

INCIDENT LOCATION:

COMPLAINANT (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

VICTIM (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

WITNESS (es) (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

SUBJECT (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

SEX AGE RACE COMPLEXION HEIGHT WEIGHT BUILD HAIR EYES

CLOTHING & OTHER CHARACTERISTICS: (e.g., Marks, Tattoos, Ect.):

DAMAGES / PROPERTY MISSING: (REPORTING OFFICER'S NARRATIVE)

POLICE DEPARTMENT REPORTED TO: CASE NUMBER: DATE: TIME:

PREPARED BY: DATE: TIME: REVIEWED BY SUPERVISOR: DATE:

 INCIDENT NUMBER
SAFETY & SECURITY DEPARTMENT
INJURY / ILLNESS REPORT
CONFIDENTIAL INFORMATION - NOT FOR UNAUTHORIZED DISCLOSURE PAGE 1 of 1

INCIDENT DESCRIPTION: DATE OF INCIDENT: TIME OF INCIDENT:

INCIDENT LOCATION:

COMPLAINANT (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

NAME OF NEAREST RELATIVE RELATIONSHIP ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER:

WITNESS NAMES (Last, First, Middle Initial) ADDRESS: (Street, City, State, Zip Code) PHONE NUMBER: EMPLOYEE STUDENT STUDENT NUMBER:

INJURED / ILLNESS PERSON'S PHYSICAL CONDITION

ALERT CONSCIOUS SEMI-CONSCIOU COMATOSE OTHER

DESCRIBE INJURY / ILLNESS

WHAT ACTION WAS TAKEN

FIRST AID ADMINISTRERED BY FIRST AID ACTION TAKEN

CPR ADMINISTERED BY TIME STARTED ADMINISTERED BY TIME STARTED

ACCEPTED/REF
E.M.S. OFFERED BY WHOM EMERGENCY SERCVICES CONTACTED
USED

WHO MADE CONTACT HOW WAS CONTACT MADE TIME WHERE WAS PERSON TAKEN

OFFICER'S NARRATIVE

PREPARED BY: DATE: TIME: REVIEWED BY SUPERVISOR: DATE: